Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  Anal fistula is a disease for which different methods of treatment have been advocated time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video assisted anal fistula treatment (VAAFT) is not satisfactory due to high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated.

In Ayurveda about 2000 yrs ago Acharya Sushruta has indicated ksharsutra treatment to treat fistula-in-ano. Late professor P J Deshpandey at the faculty of Ayurveda Institute of Medical Sciences B H U; had done extensive research in this field and established a treatment module to cure this disease. In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premiere institutes in our country including AIIMS Delhi & PGI Chandigarh. Subsequently, it was concluded by I.C.M.R. that in the patients of fistula in ano, ksharsutra treatment is more effective& convenient as compared to modern surgery.

Ksharsutra is a thread coated with certain Ayurvedic medicines known for their antiseptic, debridement & healing properties. After u v sterilization this medicated thread (ksharsutra) is used under complete aseptic precautions in the patients. The patient is routinely investigated with special reference to any other associated disorder like hypertension, diabetes mellitus, tuberculosis etc. The next step lies in the proper identification& evaluation of the fistulous tract. It is mandatory to define the fistula tract wrt its depth, direction & branching pattern. This may be achieved by careful probing under expert hands using malleable probes& if required help may be taken from other investigations like x-ray fistulogram or MRI fistulogram. 

Once the tract has been clearly defined the Ksharsutra is placed in it with the help of certain instruments, under local anesthesia. This entire procedure is usually completed in ten to fifteen mins. As there is no cutting of tissues hence no bleeding, no pain & patients can go home after half an hr rest in the daycare room. The medicine-coated on the thread is gradually released in the tract. The cumulative effect of the coated drugs exerts a powerful debridement effect on the fistula tract & induces healing by the fresh & healthy granulation tissues. Thus Ksharsutra is the mechanism of drug delivery precisely at the tissues involved. 

Every seventh or tenth day the old sutra is replaced with a new Ksharsutra till there is a final cut through. It has been observed that the tract heals @ 0.5-1 cm per week. The post-operative complications like recurrence of the disease, fecal incontinence, bleeding is not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. Patient maintains his normal routine activities as usual during the treatment period. 

 At Sushruta Anorectal Institute; Rohini - New Delhi, we have been working on this disease including piles fissures & pilonidal sinus for the last 30 yrs. Here we have developed the concept of Graded KsharsutraTM which has given us a more effective & convenient way to treat anal fistula. At Sushruta Anorectai Institute we have treated on record thousands of patients of anal fistula from different states including overseas patients. We have records to prove that the patients of high anal complex fistula, those have been operated two or three times but failed to heal were successfully treated at this institute.

How to Treat Anal Fistula Naturally without Surgery

3 Foods to Avoid If You Have Hyperthyroidism

Hyperthyroidism causes the thyroid gland to produce excess hormones, which accelerates the metabolism, in turn affecting the heart, bone health, and mood. The symptoms of hyperthyroidism include increased heartbeat, insomnia, anxiety, heightened hunger, and weight loss, all of which can be controlled via medicines and a healthy diet plan.

However, there are certain foods that can worsen the condition and lead to the severity of the symptoms. These should be avoided at all costs by anyone suffering from hyperthyroidism.

- Caffeinated drinks

Caffeinated drinks can worsen hyperthyroidism symptoms by aggravating palpitations, anxiety and insomnia. These include energy drinks, coffee, black tea, alcohol, soda. It is advisable to replace these drinks with healthy herbal tea or lemon water, which are apt refreshments with multiple health benefits.

- Foods with high glycemic content

Processed refined grains lose their nutrients like vitamin B and become not only useless but harmful to the body. The high glycemic content in refined grains can cause fluctuations in your blood sugar level, which can trigger terrible mood swings. It is advised to swap these with whole grains, quinoa, oatmeal and wild rice.

- Trans fat and hydrogenated oil

Trans- fat and partially hydrogenated oil are the culprits of heart diseases. To ensure the health of your heart and reduce the chances of hyperthyroidism, it is important to minimize the consumption of all the foods that list hydrogenated oil in their ingredient list. These are cookies, margarine, cakes, donuts, French fries, crackers and many others.



3 Foods to Avoid If You Have Hyperthyroidism

 Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodothyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. Any fluctuation in the functioning of the thyroid gland can have a great impact on health. The thyroid gland is primarily responsible for energy and metabolism. This gland triggers the genes that make all the cells in the body conduct their specific jobs. But over a period of time, the optimum functioning of the thyroid may reduce because of specific reasons. The gland may start to under-produce or overproduce the thyroid hormone, which may lead to conditions known as hypothyroidism or hyperthyroidism, respectively. 

Patients with hypothyroidism may feel extreme tiredness and fatigue even though they may be sleeping more than before. An unexplained gain in weight, constipation, inability to stand cold temperatures, and constant pain in muscles and joints are some of the other symptoms of hypothyroidism. 
Hyperthyroidism, or overactive thyroid, is an endocrine disorder. Patients with this disorder may experience excessive sweating, fatigue, and intolerance to heat. They may even experience restlessness, puffy or protruded eyes, hair loss, and muscle weakness. Such patients may lose weight and are unable to sleep properly at night. In some cases, palpitations or abnormal heart rhythm may also be experienced. 
Complications of Thyroid Disorder 

Hypothyroid and hyperthyroid can cause a number of complications if patients don t take medications. It is important for you to not to ignore any of the aforementioned symptoms and speak to your doctor as soon as possible. 

Hypothyroid complications

Myxedema: This condition is characterized by slowed thinking, swelling of tissues, and accumulation of fluid around major organs like brain, lungs and/or heart. This condition may prove life-threatening if not treated on time. 
Enlarged goiter: This is characterized by enlargement of the thyroid gland because of a constant increase in the TSH levels. High cholesterol and triglycerides: This may eventually pave way for heart disease and stroke. 
Sleep apnea: Sleep apnea is a disorder that affects nighttime breathing where the brain that temporarily stops sending signals to the muscles that control breathing, or by an obstruction in the airway. This may prove fatal if left untreated. 
Low blood pressure: This means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. You may have chronic nail fungal infections and cold hands and feet if so. 
Hyperthyroid complications 

Heart disorders (cardiac arrest): If left untreated, excess thyroid hormones can lead to congestive heart failure and heart rhythm disorders. 
Osteoporosis: Too much thyroid hormones interfere with the body s ability to use calcium to build bone. This may lead to brittle bones and osteoporosis. 
Thyrotoxic crisis: This is a rare yet life-threatening complication characterized by high fever, vomiting, irregular heartbeat, and agitation. 
Hypertension or high blood pressure: It is a condition in which a patient has high blood force striking the walls of the artery An early diagnosis can help make the treatment of this disorder easier. 
Depending on the condition of the thyroid condition, it requires different ways to manage it. The conventional TSH (thyroid-stimulating hormone) and T-4 (thyroxine) blood tests will be advised and the results should provide a reasonable confirmation of the condition. If doubts still persist an ultrasound or scan can also be ordered. In case you have a concern or query you can always consult an expert & get answers to your questions!

Is Your Thyroid Gland Working Against Your Body? 

Hernia surgery is performed for the correction of a hernia which refers to the bulging of internal organs or tissues through an abnormal opening. It is easy to detect hernia through any pain or discomfort while lifting heavy objects, cough and strain during urination or bowel movements or during prolonged standing or sitting. It can be found in both men and women. The Hernia can be congenital or can be developed over a period of time. If it doesn t get better over time and also does not go away by itself, then surgery becomes the only option.

Types of Surgery
There are two types of surgery for hernia treatment. One is the conventional open method, which requires an incision in the skin directly over the hernia. The other one is the Laparoscopic hernia repair in which surgery is performed using a small telescope known as a laparoscope. In this type of surgery minimal invasions are made and the hernia is repaired with only small incisions adjacent to the hernia. Most hernia operations are performed on an outpatient basis, which means that you can go home the very same day.

Tips for early recovery

    Wear comfortable clothing with expandable waistbands.
    Keep yourself active by moving around as much as you can as it increases circulation, which further speeds up healing.
    Eat a diet rich in fibre, fresh fruits and vegetables.
    Drink lots of water and other fluids to avoid constipation.
    Do not lift any objects even if it is very light as it can bring back pain.
    Do not to pick up things from the floor as it will be difficult to bend.
    Hold a pillow against your stomach while sneezing or coughing to lessen the pain.
    Use stool softener for a few days before and after surgery to help you with your bowel movements.
    Avoid driving till the time you feel any pain and as long as you are taking narcotic pain medicines.
    Band-Aids which cover the incisions should be changed as and when needed.
    Refrain yourself from intercourse as it can be painful.
    Check with your doctor when to take a shower so as not to hurt your incisions, and make sure to gently dry your incisions and replace the Band-Aids after taking a shower.
    Do not consume any alcoholic drinks for at least 24 hours.

The tips mentioned above will definitely provide help to cope up with post surgery blues. However, in case of fever, excessive sweating, difficulty in urinating, bleeding or any prolonged pain consult your doctor immediately.

Hernia Surgery - 13 Tips to Help You Recover from it

An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.

Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.

Symptoms

Pain- Constant pain which gets worse when sitting down
Irritation around the anus, like swelling, redness and tenderness
Discharge of blood or pus
Constipation or pain while evacuation
Fever
Diagnosis
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.

Treatment
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.

Seton techniques: A seton is a piece of thread (silk, plastic) which is left in the fistula tract to treat anal fissures. This is used if a patient is at high risk of developing incontinence after fistulotomy.
Advancement flap procedures: When the fistula is considered complex, carrying a high risk of incontinence, then this advanced technique is used.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place. 

Whatever the surgical technique, one can experience minor changes in continence. Patients usually don t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.

Fistula-in-Ano or Anal Fistula - How It Can Be Treated?

Dysentery is the inflammation of the intestine that causes appearance of blood and mucous in stool. It is caused by bacteria or parasites. In this condition, the patient passes semi liquid stool many times in a day. It is a contagious disease and is transmitted via the faecal oral route. Thus, a group of people like a family living together or students in a hostel are more prone to picking up the infection. This infection is also transmitted via anal sex. 

Ayurveda is a herbal medicinal treatment, originated in India. It is known to have cure for various health problems. Usually Diarrhoea cures itself through diet change, but in case of dysentery, medication is required to combat bacteria and parasites. Some ways to treat Dysentery with Ayurvedic remedies are as follows:

Isabbael for Chronic Amoebiasis: Isabbael is a formulation that treats dysentery caused due to Amoebiasis. When the stool contains mucus and the infected patient feels a cramp before passing stool, it is considered an Amoebiasis infection. Isabbael is very good for bacillary dysentery as well. It is advised to consume 1 teaspoonful twice daily with water for 5 to 7 days for best results. 
Ambimap for dysentery: Ambimap herbal formulation possesses a multi-purpose approach to control and cure dysentery (Pravahika). It is known to treat and cure all types of parasitic infection and provides immediate relief. For best results, 1 or 2 tablets should be taken 2 to 3 times a day with water.
Churna for dysentery: Churna is a polyherbal Ayurvedic medicine in powdered form and is high beneficial in treating dysentery.
You can also opt for Ayurvedic remedies that can be formulated at home. They are as follows:

Combine powdered dry ginger root, amla powder, long and black pepper in equal proportions. It is advisable to store this dry mixture in a glass container. For best results, consume one teaspoon of this mixture with lukewarm water two times a day. 
Another great way to combat dysentery is to drink buttermilk. Just add a bit of rock salt as well as powdered roasted cumin seeds. Drink this mixture two times a day preferably with breakfast and at lunchtime. 

Dysentery - 3 Ayurvedic Home Remedies to Help Treat it 

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